OF mental health care and mentally ill

Treatment for Suicide Attempt

People who attempt suicide and have a mental health problem may benefi t from treatment of this disorder regardless of its infl uence on their mood or behaviour. They may also benefi t more directly from addressing factors that contributed to their suicide attempt. One way through which this can be achieved is by developing strategies to cope more effectively with the problems they face. The key elements of this approach include:

both client and therapist gaining a good understanding of the nature of the problems

identifying in what ways the situation could be improved: the desired goals (such as better relationship with partner)

identifying strategies by which these goals can be attained (for example, talking more, going out together, and so on).

This approach can be used with individuals as well as couples and even families. Therapy sessions may be frequent in the early stages of therapy, and then more widely spaced as the individual begins to cope better with their problems. Therapy may also involve relatively few sessions: partly because this may be the only form of therapy acceptable to those who attempt suicide, partly to facilitate early client independence (Hawton 1997). Evaluations of the effectiveness of this approach have generally supported its use. Indeed, in a meta-analysis of psychosocial interventions following suicide attempts, Van der Sande et al. (1997) found problem-focused and cognitive behavioural interventions to be the only interventions to prove effective in this group. In one study of these approaches, Salkovskis et al. (1990) compared a brief, fi ve-session cognitive behavioural and problem-solving approach with routine outpatient care. In the six months following the intervention, 25 per cent of those in the active intervention group made at least one further suicide attempt, in comparison with 50 per cent of those who did not receive the intervention. More recently, Brown and Barraclough (1997) found that people who participated in a ten-session cognitive therapy intervention were 50 per cent less likely to re-attempt suicide than participants in a usual care group over an 18month follow-up period: 24 per cent of the cognitive therapy group and 42 per cent of the usual care group made at least one subsequent suicide attempt over this period. A second strand of research has focused on working with the family left behind by people who commit suicide. For these individuals, there is evidence of some benefi t for family therapy or bereavement groups, but the evidence is limited and not strong (McDaid et al. 2009)